FY 2024 behavioral health service expansion - north side christian health center grant # H80CS12881 north side christian health center (NSCHC) was established in 1993 with a mission to provide…

FY 2024 behavioral health service expansion - north side christian health center grant # H80CS12881 north side christian health center (NSCHC) was established in 1993 with a mission to provide whole-person primary health care to underserved persons on pittsburgh's northside and surrounding urban neighborhoods. A second site was established in 2008, at the northview heights location to provide medical care and dental care; NSCHC is the only pittsburgh fqhc CO-located in a public housing community. NSCHC provides primary care, dental services and behavioral health services. About 70% of NSCHC patients identify as ethnic minority, 97% of its patients are below 200% of the federal poverty level; 18% live in public housing, 14% are uninsured; and 5.5% are homeless. The behavioral health department (BHD), which opened in 2020, is comprised of a psychologist, an lcsw and 2 LPC. The department is in the same building as the medical department. The two departments collaborate closely to implement an integrated behavioral health service and to provide a warm hand-off, when the patient is willing. The medical department screens for behavioral needs and substance use disorders; they often consult with the NSCHC pharmacist. The family medicine providers address some moud needs but must refer out for complex cases and all SUD behavioral health support. Current BHD staff treat general behavioral health diagnoses, but there is no moud treatment or psychiatry for medication management. Thus, the need for behavioral health services (BHS) for both general mental health services and substance use disorder exceeds capacity. In 2023, out of 3982 unique patients, 52% (2083/3982) had a BH (MH and/or SUD) diagnoses. Of those 2083 patients, only 26% (492/2083) received BHS; no NSCHC patient received a SUD service by the behavioral health department. The limited BHS capacity is due to multiple retirements in 2022, and a current financial inability to recruit behavioral health support staff, therapists, and psych iatry expertise. NSCHC strives to support the allegheny county health department's "plan for a healthier allegheny 2023 - 2027." the plan, published in 2023, includes the following goals: [#4] people have access to behavioral health services, including treatment for substance US disorders; and [#4.5] "reduce the suicide mortality rate…to 13 per 100,000." only 13% of allegheny county identifies as black, whereas NSCHC patients are 68% black. NSCHC is particularly focused on the supporting the county's initiative [#4.6] :"the racial disparity in death from overdose decreases." additionally, allegheny general hospital, located just 6 blocks from NSCHC also identified SUD as a high priority need in its most recent community needs assessment. This project proposes to expand the capacity, locations and the expertise of the behavioral health department and address the unmet need of the NSCHC patients. The year 1 budget includes limited renovations at the northview heights location, to expand behavioral services to this location. This project would expand the capacity by adding two therapists, one of whom would bring expertise in addiction medicine to treat SUD. IT would expand the services of the department by contracting with a psychiatrist to offer medication management and additional patient assessments. Lastly, this project aims to provide all behavioral health patients additional social supports, so that they are better able to engage with behavioral health services, adhere to and stay in treatment; this proposal includes a nurse dedicated to behavioral health care, an BH care navigator, a community health worker to connect them to services and a SUD peer to consult with on the multitude of life challenges. This would create 5557 additional appointment slots for 641 unique patients (based on NSCHC's average number of visits per patient for behavioral health)who would be referred from the medical department. Thus, NSCHC would meet over 50% of its current behavi oral health demand.